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NPI Code Detail

MEDICARE: MIL-LAKE MEDICAL TWO, PA

MEDICARE: MIL-LAKE MEDICAL TWO, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/Center
2261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1821348616
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIL-LAKE MEDICAL TWO, PA
Provider Business Mailing Address
First Line : 2401 QUANTUM BLVD
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33426-8612
Country : US
Telephone Number : 561-739-9333
Fax Number : 561-739-9911
Provider Business Practice Location Address
First Line : 2401 QUANTUM BLVD
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33426-8612
Country : US
Telephone Number : 561-739-9333
Fax Number : 561-739-9911
Authorized Official
Title or Position : ADMINISTRATOR
Name : DR. DAVID ABELLARD
Credential : M.D.
Telephone Number : 561-433-4446
Provider Enumeration Date : 09/19/2012
Last Update Date : 09/19/2012

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Directions to “MIL-LAKE MEDICAL TWO, PA ” Practice Location

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